title: Supporting the adolescent mother-infant relationship: preliminary trial of a brief perinatal attachment intervention.
abstract: The purpose of this study is to test a brief, attachment intervention added to routine maternity care that aims to improve the adolescent mother-infant relationship during transition to motherhood. A pre-test, post-test, peer-control-group trial was set in a large tertiary maternity hospital in Melbourne, Australia. Participants were multi-cultural, pregnant adolescents (n = 97). The two-session 'AMPLE' intervention was provided in late pregnancy and neonatally. The main outcome measure was mother-infant interaction quality at age 4 months, blind-coded using the Emotional Availability Scales (EAS) (fourth edition). Study acceptability was high: participation rate 82.9 % and completion rate 75.3 %. Thirty-five participants received the intervention plus usual care (intervention group) and 38 received usual care (control group). There were no pre-test between-group differences across demographic, psychosocial or obstetric domains. At post-test, mother-infant interaction was significantly better in the intervention group. MANOVA analyses showed an overall intervention effect on emotional availability in 20 min of free play (n = 73), F (6,65) = 5.05, p < .01, partial η (2) = .32, and in 25 min of play plus brief separation-reunion (n = 55), F (6,48) = 2.72, p = .02, partial η (2) = .25. T tests showed significant between-group differences in specific EAS subscales. All effect sizes were medium-large. This promising intervention appears to exert a clinically meaningful effect on the adolescent mother-infant relationship. Further research is warranted to replicate the findings and confirm causality. The study suggests a brief attachment focus, incorporated into routine maternity care, could influence the developmental trajectory of infants of young mothers from birth.
authors.affiliation: Centre for Women's Mental Health, Royal Women's Hospital, Flemington Road, Melbourne, VIC, 3052, Australia, susan.nicolson@thewomens.org.au.
authors.forename: Susan
authors.initials: S
authors.lastname: Nicolson
authors.forename: Fiona
authors.initials: F
authors.lastname: Judd
authors.forename: Frances
authors.initials: F
authors.lastname: Thomson-Salo
authors.forename: Sarah
authors.initials: S
authors.lastname: Mitchell
mesh_terms: D000293:Adolescent; D001315:Australia; D016022:Case-Control Studies; D002657:Child Development; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D007223:Infant; D008425:Maternal Behavior / Q000523:psychology*; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology*; D009769:Object Attachment; D018743:Perinatal Care; D011247:Pregnancy; D011253:Pregnancy in Adolescence; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome